When pharmacists incorporate clinical practice into their routine, barriers and facilitators influence the implementation of patient care services. Three focus groups were conducted with 11 pharmacists who were working for the Farmacia Popular do Brasil program on the establishment, implementation, and consolidation of clinical pharmacy services. The perception of the pharmacists in Brazil about the program was that it facilitated access to health care and medication. The distance between neighboring cities made it difficult for patients to return for services. Lack of staff training created a lack of communication skills and knowledge. The pharmacists wanted to have increased technical support, skill development opportunities, and monitoring of researchers who assessed progress of the service. Pharmacists overcame many of their insecurities and felt more proactive and committed to quality service. Positive experiences in service implementations have shown that it is possible to develop a model of clinical services in community pharmacies.

Establishment, Implementation, and Consolidation of Clinical Pharmacy Services in Community Pharmacies: Perceptions of a Group of Pharmacists

Objectives. To evaluate first-year doctor of pharmacy (PharmD) students' communication apprehension, outcome expectations, and self-efficacy for communication over the duration of a 15-week patient-counseling course.Design. First-year PharmD students (n=94) were asked to complete a 47-item, self-administered questionnaire on 3 occasions over the duration of the Nonprescription Drugs/Patient-Counseling course during the fall 2009 and 2010 semesters.Assessment. Eighty-seven of 94 students completed the survey instrument across data collection periods. There were significant reductions in total communication apprehension scores and in the communication apprehension subscores for meetings and public speaking, and significant increases in self-efficacy over time. No differences were found for outcome expectations of communication scores or the subscores for interpersonal conversations and group discussion.Conclusions. Communication apprehension may be decreased and self-efficacy for communication increased in ...

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The Influence of a Patient-Counseling Course on the Communication Apprehension, Outcome Expectations, and Self-Efficacy of First-Year Pharmacy Students

During the process of implementation of clinical pharmacy services, internal and external factors may favor or hinder the incorporation of care into the hospital routine. This study aimed to understand the perceptions of a group of hospital pharmacists and other professionals of the implementation of clinical pharmacy at a high complexity public hospital in Brazil. A focus group with 16 pharmacists and interviews with tree key stakeholders including managers in the pharmaceutical, medical, and nursing profession were conducted to understand their perceptions of the implementation clinical pharmacy services in a high complexity public hospital in Brazil. The service proposal was presented to the selected participants before conducting the focus group. Professionals with an overview of the hospital and influence on the relevant departments for the implementation of clinical pharmacy at the institution were selected. Data collected were transcribed and analyzed using the Bardin Content Analysis technique. Data analyzed were systematized into categories and registration units. The methodology involves the organization and analysis of reported content to make inferences. The data obtained were divided into four categories: “Perception of the current situation”, “Implementation expectations”, “Barriers to implementation”, “Implementation facilitators”. Participants discussed the stagnation of clinical activities of the pharmaceutical profession in Brazil, a reality that results from a lack of clinical training in the country. Pharmacists expressed their expectations for changes in professional performance. According to the managers, such services would positively affect clinical outcomes for patients. Gaps in academic education, lack of knowledge, and poor communication skills were barriers reported in this study. Pharmacists’ clinical experience has been reported to facilitate the provision of services. This study highlights factors that may influence the implementation of clinical pharmacy services in the institution analyzed, such as resistance, fear, and frustration as barriers, as well the experience in clinical pharmacy of some pharmacists in the institution was one of the facilitators most cited by participants. This knowledge may aid future planning for the implementation of clinical pharmacy in hospitals.

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Perceptions of a group of hospital pharmacists and other professionals of the implementation of clinical pharmacy at a high complexity public hospital in Brazil

Community pharmacy practice setting provides the opportunity for pharmacists to be \"the most accessible health care providers”, however still the role of the pharmacists considered as product oriented and mainly concentrate on distribution and prescription filling. In order for advanced pharmacy practice to become an effective reality we must be willing to admit certain challenges embodied by barriers to pharmaceutical care. Thus, this study considered as the first of its kind to be held in UAE community pharmacies aimed to explore the extent of obstacles to the professional services provided through community pharmacies in the UAE and to provide baseline data critical to inform the development of strategies to success implementation of pharmaceutical care. Descriptive Qualitative Survey was conducted, which involved exploring data from randomly selected pharmacists working in different UAE community pharmacies. The respondents asked to indicate the degree of the agreement to (37) barriers to the application of pharmaceutical care, using 5-point Likert-type scale. SPSS software program for windows Version (20) used to perform statistical analysis needed. Frequencies, percentages, means and standard deviations were used to describe pharmacists' responses. MannWhitney U Test and Kruskal-Wallis Test were used to assess the association between these barriers and demographic characteristics. Overall results showed that; lack of time (64.7%), insufficient staff number (61.9%) and lack of motivation (61.1%) are the main barriers to provide pharmaceutical care by community pharmacists in the UAE. The provision of pharmaceutical care is not regarded as such over the seven emirates. Although same barriers can be identified, their local importance showed some differences. There were significant differences in gender, age and experience in the estimate of barriers. Pharmacists expressed a willingness to implement pharmaceutical care practice but have recognized a number of barriers to successful implementation.

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Barriers to the implementation of Pharmaceutical Care into the UAE community pharmacies

Osteoporosis has significant impact on healthcare costs and quality of life. Amongst the models for collaborative disease state management services published internationally, there is sparse evidence regarding the role of community pharmacists in the provision of osteoporosis care. Hence, the aim of our study was to explore community pharmacists’ opinions (including the barriers and facilitators) and scope of osteoporosis disease state management services by community pharmacists in Malaysia, informing a vision for developing these services. Semi-structured individual interviews and focus groups discussions were conducted with community pharmacists from October 2013 to July 2014. Three trained researchers interviewed the participants. Interviews were recorded and transcribed verbatim. Data were analyzed thematically using an interpretative description approach. Nineteen community pharmacists with 1–23 years of experience were recruited (in depth interviews: n = 9; focus group discussions: n = 10). These participants reflected on their experience with osteoporosis-related enquiries, which included medication counseling, bone density screening and referral of at-risk patients. Key barriers were the lack of numerous factors: public awareness of osteoporosis, accurate osteoporosis screening tools for community pharmacists, pharmacists’ knowledge on osteoporosis disease and medications, time to counsel patients about bone health, collaboration between pharmacists and doctors, and support from the government and professional body. The pharmacists wanted more continuing education on osteoporosis, osteoporosis awareness campaigns, a simple, unbiased osteoporosis education material, and inter-professional collaboration practices with doctors, and pharmacists’ reimbursement for osteoporosis care. The involvement of community pharmacists in the provision of osteoporosis disease state management was minimal. Only ad-hoc counseling on osteoporosis prevention was performed by community pharmacists. Development and trial of collaborative osteoporosis disease state management services in community pharmacy could be facilitated by training, support and remuneration.

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A qualitative study of community pharmacists' opinions on the provision of osteoporosis disease state management services in Malaysia

OBJECTIVE: study objective is to evaluate the pharmacists’ perception towards the importance of pharmaceutical care in respective practice site and also self-evaluation to determine the competence in managing clinical practices. METHODOLOGY: A questionnaire was designed to explore the pharmacist’s understanding, knowledge, and their perceptions on the philosophy of pharmaceutical care and barriers to its provision, and also the current pharmacy practice. The cross-sectional study was conducted, which involved exploring and collecting data from community and hospital pharmacists in the West and East Malaysia (Sabah and Sarawak), employing the selfadministered mailed questionnaire approach. Pharmacists recruited by systematic random sampling technique. The data was analyzed using the SPSS® (Statistical Package for the Social Sciences) software program for windows® Version (12.0), and Microsoft Office Excel 2003. RESULTS: Of the 927 questionnaires mailed to the hospital and community pharmacists, 269 were returned back. In terms of the responses from both the hospital and community pharmacists; provide a response rate of 45.8% and 18.5%, respectively. The medians age of the hospital and community pharmacy respondents were found to be 29 and 36 years old, respectively (mean 31.8 ± 7.03 and 36.8 ± 8.78 respectively). It was observed that most of the respondents from the both the hospital and community pharmacy settings tend to be in the younger age group (24-35 years) (77%) and (48.2%) respectively, (P< 0.001, Chi-square). 2-Proportions Sample test showed highly a significant value of p < 0.05 for these variables when tested to estimate the differences in proportions (EDP). The overall of the community pharmacy respondents for this category of activities were (81%) and this was significantly higher (p < 0.05; Chi-Square, 2-sided) than these stated by the hospital pharmacy respondents (60%). CONCLUSION: Hospital pharmacy respondents showed higher perceptions of the importance and competence to the most of the current pharmacy practice activities compared to their counterparts in community pharmacy settings. Whereas less than 50% of community pharmacy respondents indicated that they were competent to practice the dispensing activities and agreed about its importance .

http://www.technicaljournalsonline.com/ijpsr/VOL%20I/IJPSR%20VOL%20I%20ISSUE%20II%20OCTOBER-DECEMBER%202010/Article%201%20IJPSR%20VOL%20I%20ISSUE%20II.pdf

Pharmacist perception to importance and self-competence in pharmacy practice.

Communication Apprehension among Malaysian Pharmacy Students: A Pilot Study

Objective: In order to explore pharmacists’ perceived practicability, importance, and their competence towards achieving and developing the pharmaceutical care practice, we aimed to develop a scale to predict the trilogy of professional skills.
Methodology: The process of instrument construction and development was carried out in four stages. Validity Phase: The opinions of the lecturers of the School of Pharmaceutical Sciences (USM). Phase criteria of item done by mean and standard deviations with pharmacists at national poison center and postgraduate students of Malaysia. Reliability Phase: The Reliability Test with pharmacists at National Poisoning Center and postgraduate students of Malaysia. Finally Pilot Phase: The pilot test with the pharmacists at Pulau Pinang, Malaysia. Data analysis was done by using statistical package for social sciences (SPSS 13®) for windows, both descriptive and inferential statistics used to present findings of this study.
Results: For section exploring the pharmacists’ perception on their understanding and comprehension of pharmaceutical care, the items means were in range of 1.88 to 3.88 which indicated a midrange sense of disagreement / agreement with all statements. Items with a mean of greater than 4.00 or less than 2.00 indicated and standard deviation less than 1.00 indicated inadequate variability. Items with a mean of greater than 4.00 or less than 2.00 indicated skewness, and standard deviation of less than 1.00 indicated inadequate variability. For the importance scale, the items means were ranged from 2.84 to 3.78 which showed a midrange sense of not important / important in all statements. The data from the 32 pharmacists was used for the internal consistency. The internal consistency coefficient of importance scale was 0.868 and there were 15 items in scale. The modified questionnaire was mailed to 53 community pharmacists and 13 sets were sent to the hospital pharmacists at the General Hospital (GH) of Pulau Pinang.
Conclusion: The findings of study concluded the good internal consistency and reliable tool to assess the relative professional skills of pharmacists involved in either community or hospital base practice.

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Wasif S Gillani

Papers

Pharmacist perception to importance and self-competence in pharmacy practice.

Communication Apprehension among Malaysian Pharmacy Students: A Pilot Study

Development and Reliability Assessment of Trilogy Scalewith Practicability, Competence and Importance of PatientOriented Services